Faculty of Medical Sciences, Universidade Estadual de Campinas, Tessália Vieira de Camargo, 126 Cidade Universitária, Campinas, São Paulo 13083-887, Brazil.
Campinas Poison, Control Center, University of Campinas, R. Vital Brasil, 251 Barão Geraldo, Campinas, São Paulo 13083-881, Brazil.
J Anal Toxicol. 2022 May 20;46(5):577-581. doi: 10.1093/jat/bkab058.
Considering that the use of psychoactive substances (PSs) is a risk factor to either higher intensity or frequency of suicidal behavior, hair analysis was conducted to investigate the most consumed PSs (opiates, amphetamine stimulants, marijuana, cocaine and heroin) in patients who attempted suicide and received urgent care at emergency service. Hair samples were extracted using methanol and sonicated under heating and then analyzed using liquid chromatography-tandem mass spectrometry. During validation, the method complied with international recommended criteria, with limits of detection between 0.0025 and 0.05 ng/mg and linearity between 0.1 and 4 ng/mg for methamphetamine, 3,4-methylenedioxymethamphetamine (MDMA), morphine, amphetamine, 6-acetylmorphine, 3,4-methylenedioxyamphetamine (MDA), fenproporex, diethylpropion and codeine; between 0.025 and 1 ng/mg for tetrahydrocannabinol (THC), benzoylecgonine and cocaethylene and between 0.25 and 10 ng/mg for cocaine and mazindol. A total of 109 hair samples were analyzed and segmented in 404 parts. Among all analyzed samples, 30.3% were positive for at least one PS (n = 33), such as cocaine (90.9%), codeine (12.1%), morphine (3.0%), MDMA (3.0%) and THC (3.0%). In segmental analysis of cocaine positive samples (n = 30), 76.7% of the samples indicated recent exposure to cocaine (<1 month). This same behavior was observed when analyzing codeine (n = 4) and morphine (n = 1). THC positive samples indicated exposure dated ∼4 months prior. In conclusion, the method was validated following international recommendations for the 12 most consumed PSs in Brazil, as well as two of the most common found metabolites.
考虑到使用精神活性物质（PSs）是自杀行为强度或频率更高的一个风险因素，因此对接受紧急服务紧急护理的自杀未遂患者进行了毛发分析，以调查他们最常使用的 PSs（阿片类药物、苯丙胺类兴奋剂、大麻、可卡因和海洛因）。使用甲醇提取毛发样本，在加热下进行超声处理，然后使用液相色谱-串联质谱法进行分析。在验证过程中，该方法符合国际推荐标准，检测限为 0.0025 至 0.05ng/mg，线性范围为 0.1 至 4ng/mg 的有甲基苯丙胺、3,4-亚甲二氧基甲基苯丙胺（MDMA）、吗啡、苯丙胺、6-乙酰吗啡、3,4-亚甲二氧基苯丙胺（MDA）、芬普雷司、右苯丙胺和可待因；检测限为 0.025 至 1ng/mg 的有四氢大麻酚（THC）、苯甲酰爱康宁和古柯乙醇，检测限为 0.25 至 10ng/mg 的有可卡因和马吲哚。共分析了 109 个毛发样本，并将其分成 404 个部分。在所有分析的样本中，有 30.3%（n=33）至少有一种 PS 呈阳性，如可卡因（90.9%）、可待因（12.1%）、吗啡（3.0%）、MDMA（3.0%）和四氢大麻酚（3.0%）。在可卡因阳性样本（n=30）的分段分析中，76.7%的样本显示最近（<1 个月）接触过可卡因。在分析可待因（n=4）和吗啡（n=1）时也观察到了同样的行为。THC 阳性样本表明接触时间约为 4 个月前。总之，该方法经过验证，符合巴西最常使用的 12 种 PSs 以及两种最常见代谢物的国际建议。
